Increased understanding of the dynamic and multifaceted nature of an individual's illness experience and fully conceived interventions responding to an individual's fluctuating antiretroviral adherence are critical to addressing health disparities among the HIV-positive community. At present, few established HIV health promotion interventions exist that comprehensively address the needs of poor, minority, and non-adherent HIV-positive individuals and that have been validated in efficacy trials. For the past five years, the Prevention and Access to Care and Treatment (PACT) Project, an existing community-based HIV health promotion program affiliated with Partners In Health and the Brigham and Women's Hospital, has used the concept of peer health promotion to address the needs of this population in Boston's underserved neighborhoods. Increasingly, PACT health promoters need a more standardized version of the intervention that links closely to theoretical models and community stakeholder input. Through an R21 exploratory/developmental grant mechanism, we answer program announcement PAR-05- 026 with the following specific aims: A) Build and capacitate a community advisory team that includes health promoters and HIV-positive individuals. B) Use CBPR to develop HOPE (Health Promotion through Empowerment), an enhanced HIV health promotion and adherence intervention. C) Use CBPR to test the feasibility and acceptability of HOPE among 40 PACT-active participants. Secondary outcomes will include HIV viral load and CD4 cell count, HIV knowledge, adherence, and HIV self-management skills. This study would enable the development and pilot testing of an enhanced HIV health promotion intervention primarily designed by community health promoters and marginalized HIV-positive patients. If feasible and acceptable, HOPE would be tested in a larger randomized controlled effectiveness trial. The creation and refinement of HOPE would also enable replication of the PACT health promotion intervention in other communities and chronic diseases, like mental illness, diabetes, and heart failure. [unreadable] [unreadable] [unreadable]